The document discusses the principles and techniques of exodontia, or tooth extraction. It begins by defining exodontia as the painless removal of a whole tooth or root with minimal trauma. It then lists the minimum essential equipment needed and discusses pre-surgical evaluation including clinical and radiographic examination. Key techniques covered include forceps extraction, elevator extraction, and open or transalveolar extraction involving bone removal. Post-operative care of the extraction socket is also addressed.
brief description on posterior superior alveolar nerve block.
its uses in dentistry, technique and action. locating PSA nerve is easy and this is the most used nerve block in dentistry.
brief description on posterior superior alveolar nerve block.
its uses in dentistry, technique and action. locating PSA nerve is easy and this is the most used nerve block in dentistry.
Dental Management of a Medically Compromised Patients - Presented by Dr. Shweta and Parray as a part of Dhaka Dental COllege OMS Department Weekly Presentation Program
All the mistakes are rectified.Complete and precise knowledge about EXODONTIA .I would like to again focus on compatibility of this ppt;some pictures differ from original one.Animations and Transitions added are not visible .Good for beginners to understand and remember.Images give you better way to grasp.Enjoy and have fun watching this ppt.
Dental Management of a Medically Compromised Patients - Presented by Dr. Shweta and Parray as a part of Dhaka Dental COllege OMS Department Weekly Presentation Program
All the mistakes are rectified.Complete and precise knowledge about EXODONTIA .I would like to again focus on compatibility of this ppt;some pictures differ from original one.Animations and Transitions added are not visible .Good for beginners to understand and remember.Images give you better way to grasp.Enjoy and have fun watching this ppt.
Definition: The ideal tooth extraction is painless removal of the whole tooth or tooth root with minimal trauma to the investing tissues so that the wound heals uneventfully and no post operative prosthetic problem is created.
Definition
Types
Indications
Local Contraindications
Systemic Contraindications
Pre Operative Assessment
Dental Surgeon Chair Positions
Post Operative Assessment
Mechanical principles involved in tooth extraction
Lever
Wedge
Elevators
Role of Forceps
Principles of elevator and forceps use
Motions of Forcep's
Procedure for closed extraction
Principles of Exodontia (teeth extraction) by Dr., Giath Gazal, 2020Giath Gazal
Indication and contra indication for extraction
Patient and surgeon preparation
Proper Chair Position for Extraction
Proper Position for operator
Steps of simple extraction
Types of exodontia
Elevators (selection + rules & techniques)
Forceps (selection + rules & techniques)
Post-extraction care & instruction
Exodontia /certified fixed orthodontic courses by Indian dental academy Indian dental academy
The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.
How to Make a Field invisible in Odoo 17Celine George
It is possible to hide or invisible some fields in odoo. Commonly using “invisible” attribute in the field definition to invisible the fields. This slide will show how to make a field invisible in odoo 17.
Palestine last event orientationfvgnh .pptxRaedMohamed3
An EFL lesson about the current events in Palestine. It is intended to be for intermediate students who wish to increase their listening skills through a short lesson in power point.
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
For more information, visit-www.vavaclasses.com
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Unit 8 - Information and Communication Technology (Paper I).pdfThiyagu K
This slides describes the basic concepts of ICT, basics of Email, Emerging Technology and Digital Initiatives in Education. This presentations aligns with the UGC Paper I syllabus.
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Honest Reviews of Tim Han LMA Course Program.pptxtimhan337
Personal development courses are widely available today, with each one promising life-changing outcomes. Tim Han’s Life Mastery Achievers (LMA) Course has drawn a lot of interest. In addition to offering my frank assessment of Success Insider’s LMA Course, this piece examines the course’s effects via a variety of Tim Han LMA course reviews and Success Insider comments.
Read| The latest issue of The Challenger is here! We are thrilled to announce that our school paper has qualified for the NATIONAL SCHOOLS PRESS CONFERENCE (NSPC) 2024. Thank you for your unwavering support and trust. Dive into the stories that made us stand out!
3. “ Exodontia is the
painless removal of the whole tooth or root,
with minimal trauma to the investing tissues,
so that the wound heals uneventfully &
no post-operative prosthetic problem is created”
~ Geffory L. Howe
4. “7 Minimum Essentials”
• Radiograph
• Anesthetic
• Forceps & elevators
• Flap tray
• Light
• Efficient assistance
• Suction apparatus
Raffles founded modern Singapore
Sir Thomas Stamford Raffles
(1781 – 1826)
6. Clinical Evaluation of teeth for removal
• assess difficulty of extraction.
• Access to tooth: if mouth opening of PT is
compromised-surgical extraction.
• Mobility of tooth: teeth with less than
normal mobility should be assessed for
hypercementosis and ankylosis----surgical
removal
6
8. • If adjacent tooth has amalgam
restoration or undergone endodontic
therapy, care must be taken while using
elevators.
8
9. Radiographic Examination of tooth for removal
• If it is a I° tooth, its relationship with a
succedaneous tooth should be visible
• Configuration of roots- If excess curvature
surgical extraction
• Length of roots
• Hypercementosis
9
10. • Relationship of associated vital structures
– For Max. teeth relation with max. sinus.
– For Mand. Molars inferior alveolar canal
– For Mand premolars relation with mental
foramen 10
11. Patient & surgeon Preparation
• All patients should be considered as having
blood born disease.
• Surgeon should wear surgical gloves, mask,
eyewear with side shield, long sleaving gowns.
• If surgeon has long hair it should be covered
with surgical CAP. 11
12. Order of extraction
Lower teeth are removed before the upper &
posteriors are removed before anteriors to
prevent bleeding from socket obscuring field
of operation (prof.J.Moore)
12
14. •Over retained deciduous teeth
•Teeth involved in significant infection
•Patients inability to afford more optimal treatment
because of limited finances or time.
•teeth in the line of #
16. Contraindications
Local :
H/o radiation therapy in the area
Acute pericoronal infection
Teeth involved with central hemangioma/vascular
malformation
Teeth associated with a tumor
17. Contraindic atr io n s : -
Systemic : -
Uncontrolled metabolic diseases
Malignant diseases
Uncontrolled Cardiac conditions
Pregnancy
Sever blood dyscrasias
20. • Pain and anxiety control
•Position of the patient
•Position of the operator
•Clear access to and vision of the surgical field
•Use of controlled force- elevators & forceps
•Unimpeded path of removal
PRINCIPLES OF EXODONTIA
22. PRINCIPLES OF ELEVATION
1. Lever principle:
Fulcrum is between the load & the effort arm. For mechanical
advantage the effort arm must be longer than the load or
resistance arm.
36. FORCEP EXTRACTION OF DECIDUOUS
TEETH
• Upper & lower anteriors & canines-Extracted similar to the
permanent tooth
• Care should b taken with the extraction of the primary molars due
to the developing permanent premolars underneath them
• Broken primary molar teeth can be elevated using the right angled
Warwick James elevator.
37.
38. INTRA ALVEOLAR EXTRACTION
• It means direct access is gained on the tooth to be extracted.
• It is carried out with the help of dental forceps and elevators.
39. Forceps Technique
Indications
• Fairly mobile teeth,
• Extraction of single tooth,
• Extraction of multiple teeth which are scattered.
Contraindications
• In complicated extractions,
• Deformed roots,
• Hard tissue pathology of roots like hyper-cementosis etc.
• Badly destroyed teeth.
40. Advantages –
• It causes the least amount of trauma.
• Promotes retention of a satisfactory blood clot.
• Favours rapid healing.
41. Various movement for extraction of individual
tooth
Upper central, lateral,
canine, first pre-molar,
second pre-molar
First apical slight labial/buccal
slight palatal rotation with
traction
Upper molars First apical buccal palatal
deliver the tooth buccaly
Lower central, lateral,
canine, first pre-molar,
second pre-molar
First apical slight labial/buccal
slight lingual rotation with
traction
Lower molars First apical buccal lingual
deliver the tooth buccaly
42. Elevator technique
Indications
• To luxate teeth which cannot be engaged by beaks
of forceps
eg: impacted, malposed or grossly destructed teeth.
• To remove roots
43. DISADV
• Fracture of maxilla or mandible.
• Fracture of the alveolar process.
• Injuring the soft tissue if proper care is not taken.
• Penetrating into the maxillary sinus, during extraction of
maxillary posterior teeth.
• Forcing a maxillary root into the maxillary sinus or forcing the
apical third of the root of the lower third molar into the
mandibular canal or into submaxillary or pterygomandibular
space depending upon the position of the impacted third
molar.
44. Rules to be followed when using an Elevator –
• Never use an adjacent tooth as a fulcrum unless
that tooth is also to be removed.
• Never use the buccal plate at the gingival line as
fulcrum except in third molars.
• Always use finger guards to protect the patient in
case the elevator slips.
• Use interseptal bone as fulcrum.
• Avoid using an elevator to luxate a tooth which has
a tooth distal to it.
56. OPEN METHOD/
TRANS-ALVEOLAR EXTRACTION
Consists of dissecting the tooth or root from bony
attachments by removal of some bone investing the
tooth/roots, which are then delivered by use of elevators
and/or forceps
57. Ind ications : -
Root # during forcep extraction
Need for excessive force that may lead to # root, bone
or both
Dilacerated roots
Ankylosed tooth
Impacted/submerged tooth
Endanger to anatomical structures
58. Advantages:
• Removal of teeth lying in difficult position without damaging the
neuro-vascular bundle.
• Fracture of bone avoided.
• Less danger of creating an oro-antral fistula.
• Less chance of tearing of soft tissues & fracture of large pieces
of alveolar bone.
59. Steps in Trans-alveolar extraction:
• Local anesthesia.
• Incision and reflection of mucoperiosteal flap.
• Removal of bone/ bone cutting.
• Sectioning of tooth, if required.
• Elevation of the tooth.
60. • Smoothening of sharp edges of bone.
• Control of bleeding.
• Debridement of the socket.
• Suturing the flap.
• Suture removal & post-operative follow up.
62. Firm, continuous stroke, deep to the bone
Avoid vital adjacent structures
Base should be wider than the apex of the flap
Flap should either include or exclude a papila
Relieving incisions should cross the mucogingival junction
so that flap can be reflected well
healing takes place across and not on the incision line
(so length does not affect the healing time)
63. Bone removal:
• Either with a dental bur or by the use of a chisel. (hand or mallet pressure).
Using Chisel & mallet
is usually used for removal of bone in maxilla because the bone is soft.
• Adv: - post operative edema will be less
- less time consuming.
• Disadv: - in conscious patient, the sensation produced by chisel &
mallet is objectionable.
- problem to TMJ.
- chances of slippage of instrument.
- chances of fracture of jaw.
• Contraindications: -if the bone surrounding the tooth is very hard & sclerotic
- if the mandible is thin.
- if the root is brittle.
64. Using bur:
• Bone may be removed with bur either by simply cutting it using a No.8 or 10
round bur or flat fissure pattern or by using the ‘postage stamp method.’
• The bur must never be allowed to over-heat during bone removal. Constant
irrigation should be done with sterile normal saline.
Postage stamp method
• In this technique, rows of small holes is made with a small round bur & then
they are joined together with either bur or chisel cuts.
• This simple procedure will minimize the risk of damage to the surrounding
tissues & limits the cutting.
• Disadv: - post operative pain & edema
- delayed wound healing
65. Chisel vs Bur technique
Criteria Chisel & mallet Bur
Technique Difficult Easy
Patient
acceptance
Not tolerated Well tolerated
Chance of # bone High Less
Healing of bone Good Delayed
Post op edema Less More
Dry socket Less More
Post op infection Less More
71. Stobie technique – extraction of
multiple mandibular anteriors by
using elevators b/w teeth
72. Policy for leaving root fragments
• 3 conditions must exist for a tooth to be left in
the alveolar process
• Root fragment must be small
• Root deeply embedded in bone
• Root must not be infected
73. POST OPERATIVE CARE
• Care of the empty socket
• Post operative instructions
• Prescription of antibiotics and analgesics
74. REFEREENCES
• THE EXTRAACTION OF TEETH, SECOND EDITION
-GEOFFREY L. HOWE
• PRINCIPLES OF ORAL SURGERY, FOURTH EDITION
-J.R. MOORE
• ORAL & MAXILLOFACIAL SURGERY, VOL-2
-DANIEL M. LASKIN
• TEXTBOOK OF ORALMAXILLOFACIAL SURGERY
-NEELIMA MALIK
• TEXTBOOK OF ORAL SURGERY
-F. D. Fragiskos
Editor's Notes
Coz xtractn is a surgical procedure so thorugh medical history on general health, existing illness, medications, allergies, vital signs, any existing cvs, pulmonary, hematological or immunocompromised conditions is a must.
31
Other indications: Pre-radiation therapy, pre-prosthetic x’n, economics, supernumerary teeth
Maxillary- 60 degree, 8cm below (3inches) below the shoulder level
Mandibular- parallel , 16 cm (6 inches) below the elbow level
Bone removal is guttering so that we can get a purchase point for the application of the elevators. Describe about cuts using chisel…. Also postage stamp method.